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Uterinerupture at 28 weeks of gestation after laparoscopic myomectomy â€“ a case report There are many reasons for sterility, and uterine malformations are of the greatest concern. Among uterine disorders, myomas play a significant role and are present in 27% of infertile women. The occurrence of myomas is frequent - 20-40% in women of reproductive age. Thus, for those infertile patients surgical treatment may be needed to preserve an opportunity to conceive. This case report refers (...) to an uterinerupture at 28 weeks of gestation after laparoscopic myomectomy (3 months before conceiving). The myomectomy was conducted correctly and two layers of sutures on the myometrium were performed. The purpose of the myomectomy in a young woman should be well considered. In cases of infertility, removal of the lesions is usually necessary to give the patient a chance of pregnancy. At the same time, the risk of uterinerupture is increased. There are some suggestions referring to myomectomy to reduce
, 5691 infants). Women in the planned early birth group had more positive experiences compared with women in the expectant management group.No clear differences between groups were observed for endometritis; postpartum pyrexia; postpartum antibiotic usage; caesarean for fetal distress; operative vaginal birth; uterinerupture; epidural analgesia; postpartum haemorrhage; adverse effects; cord prolapse; stillbirth; neonatal mortality; pneumonia; Apgar score less than seven at five minutes; use (...) Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37 weeks or more). Prelabour rupture of membranes (PROM) at term is managed expectantly or by planned early birth. It is not clear if waiting for birth to occur spontaneously is better than intervening, e.g. by inducing labour.The objective of this review is to assess the effects of planned early birth (immediate intervention or intervention within 24 hours) when compared with expectant
Successful management of the recurrent uterinerupture after the uterine septum resection 29629313 2019 02 26 2214-9112 8 2015 Oct Case reports in women's health Case Rep Womens Health Successful management of the recurrent uterinerupture after the uterine septum resection. 13-16 10.1016/j.crwh.2015.10.001 Kasapoglu Taner T Department of Obstetrics and Gynecology, Hacettepe University, Faculty of Medicine, Turkey. Kasapoglu Dila D Department of Obstetrics and Gynecology, Hacettepe University (...) , Faculty of Medicine, Turkey. Deren Ozgur O Maternal-Fetal Medicine Unit, Department of Obstetrics and Gynecology, Hacettepe University, Faculty of Medicine, Turkey. eng Case Reports 2015 10 23 Netherlands Case Rep Womens Health 101682122 2214-9112 Uterine septum is associated with an increased rate of recurrent miscarriages which can be reduced significantly by performing endoscopic resection. Perinatal outcome improvement due to resection is favorable but still remains controversial. Uterinerupture
FHR o Uterine activity o Vaginal loss (liquor amount, colour consistency) • If oxytocin commenced, monitor as for oxytocin • If oxytocin not commenced and observations normal and no contractions, then ongoing monitoring as for latent first stage • If FHR or liquor abnormalities discuss/refer/consult • Encourage mobilisation to promote onset of uterine contractions Yes Yes No No Recommend immediate commencement of oxytocin Clinical concerns identified? ARM Artificial rupture of membranes; CTG (...) Flowchart: Induction of labour, Artificial rupture of membranes (PDF, 106kB) Queensland Health State of Queensland (Queensland Health) 2017 http://creativecommons.org/licenses/by-nc-nd/3.0/au/deed.en Queensland Clinical Guidelines, email@example.com Queensland Clinical Guidelines www.health.qld.gov.au/qcg Artificial rupture of membranes Queensland Clinical Guideline: Induction of labour Flowchart version F17.22-4-V5-R22 Indications • After cervical ripening method • Favourable cervix
Tiny Tips: Approach to Abnormal Uterine Bleeding Tiny Tips: Approach to Abnormal Uterine Bleeding - CanadiEM Tiny Tips: Approach to Abnormal Uterine Bleeding In , by Zoe Polsky July 14, 2017 Whether the patient is an expecting mother, a post-menopausal woman, or a young adolescent, abnormal uterine bleeding is distressing for the patient, and often overwhelming for learners. Consider the ‘ CAUSES OF bLOOD ’ to better tailor your investigations and management. C ancer A bruption U rogenital (...) infections (PID, endometritis, salpingitis) S evere menorrhagia E ctopic pregnancy S pontaneous abortion O varian cyst rupture F ibroid (Leiomyoma) b … L ocation of placenta- placenta previa O varian torsion O nset after delivery – Post-Partum Hemorrhage D rugs – anticoagulants, antipsychotics, corticosteroids, hormone replacement This post was copyedited by Dat Nguyen-Dinh (@dat_nd). Reviewing with the Staff The above mnemonic provides a reasonable, but not comprehensive, differential for abnormal
UterineRupture After Uterine Artery Embolization for Symptomatic Leiomyomas. There are few data regarding safety of pregnancy after uterine artery embolization. However, numerous women desire future fertility after this procedure. Uterinerupture without a history of cesarean delivery or uterine scarring is an exceedingly rare complication in pregnancy.We report a case of uterinerupture in a primigravid woman after uterine artery embolization. Her pregnancy was also complicated by placenta (...) previa with placenta increta, resulting in a favorable neonatal outcome in an otherwise life-threatening situation for mother and fetus.Uterine artery embolization is a risk factor for abnormal placentation and uterinerupture in subsequent pregnancies.
Uterine sarcoma in a 14Â year-old girl presenting with uterinerupture •Uterine sarcomas are rare in adolescents. Adenosarcomas are even more rare. Uterinerupture, as a presentation is a rare entity.•It is hard to diagnose sarcomas preoperatively. It is still hard even postoperatively due to variable morphologic features.•Experience of the gynecopathologists and oncologic surgeons is the hallmark of the treatment option.
Single versus double-layer uterine closure at cesarean: impact on lower uterine segment thickness at next pregnancy. Uterinerupture is a potential life-threatening complication during a trial of labor after cesarean delivery. Single-layer closure of the uterus at cesarean delivery has been associated with an increased risk of uterinerupture compared with double-layer closure. Lower uterine segment thickness measurement by ultrasound has been used to evaluate the quality of the uterine scar (...) after cesarean delivery and is associated with the risk of uterine rupture.To estimate the impact of previous uterine closure on lower uterine segment thickness.Women with a previous single low-transverse cesarean delivery were recruited at 34-38 weeks' gestation. Transabdominal and transvaginal ultrasound evaluation of the lower uterine segment thickness was performed by a sonographer blinded to clinical data. Previous operative reports were reviewed to obtain the type of previous uterine closure
) than that of Type B patients (10 weeks). The rudimentary uterine horn carried 4 of 5 (80%) pregnancies in the communicating group. Three case of rudimentary horn pregnancies ruptured before a gestational age of 12 weeks, and one abortion occurred after a gestational age of 12 weeks. In the noncommunicating group, 7 of 17 (41.2%) cases were RHPs, and 3 ruptured after a gestational age of 12 weeks.The diagnosis and management of the rudimentary uterine horn continues to be challenging. Medical (...) The pregnancy outcomes of patients with rudimentary uterine horn: A 30-year experience. To evaluate the presentation, assessment, treatment, and pregnancy outcomes of 22 women with a rudimentary uterine horn.We reviewed the data regarding the outcomes of patients with a rudimentary horn pregnancy (RHP) who were managed at Peking Union Medical College Hospital over the last 30 years. Twenty-two pregnant patients with a rudimentary horn have been treated at our institute over the last 30 years
; in the control group, ultrasound LUS measurement will not be performed. The mode of delivery will be decided according to standard practice at the center. The primary composite outcome will include: uterinerupture, uterine dehiscence, hysterectomy, thromboembolic complications, transfusion, endometritis, maternal mortality, fetal prenatal and intrapartum mortality, hypoxic-ischemic encephalopathy and neonatal mortality.This trial assesses the efficacy of ultrasound measurement of the lower uterine segment (...) [Lower Uterine Segment Trial: A pragmatic open multicenter randomized trial]. The data from literature show that trial of labor and elective repeat cesarean delivery after a prior cesarean delivery both present significant risks and benefits, and these risks and benefits differ for the woman and her fetus. The benefits to the woman can be at the expense of her fetus and vice-versa. This uncertainty is compounded by the scarcity of high-level evidence that preclude accurate quantification
Neonatal outcomes after the obstetric near-miss events uterinerupture, abnormally invasive placenta and emergency peripartum hysterectomy - prospective data from the 2009-2011 Finnish NOSS study. Neonatal outcomes after the maternal obstetric near-miss complications of uterinerupture, abnormally invasive placenta, and emergency peripartum hysterectomy were assessed.This case-control study was conducted as part of the Nordic Obstetric Surveillance Study (NOSS). Data on 211 newborns from 197 (...) (OR) 12.5, 95% confidence interval (CI) 6.32-24.9]. In addition, there were two neonatal deaths. The majority of cases (n = 8, 80%) were connected to uterinerupture. The risk of severe birth asphyxia diagnosis was increased compared with controls (n = 17, 8.1% vs. 0.1%, OR 137, 95% CI 82.7-226). A low umbilical artery pH (<7.05) was also observed among these neonates (28.8% vs. 1.0%, OR 28.7, 95% CI 21.5-38.2). Post-term pregnancies were relatively common among the uterinerupture cases. Adverse
Spontaneous Posterior UterineRupture in Twin-Twin Transfusion Syndrome Background The maternal and fetal risks of uterine distension in rapidly progressive twin-twin transfusion syndrome (TTTS) in the setting of prior uterine scar are poorly characterized. Case We present the case of a 42-year-old woman, G4P1201, at 21 weeks gestation with stage-1 TTTS who developed a spontaneous posterior uterinerupture necessitating emergent laparotomy and delivery of previable fetuses, possibly due (...) to prior uterine scar from a displaced intrauterine device. Conclusion TTTS may be a risk factor for uterinerupture, including uterinerupture in atypical anatomic locations. Prior unrecognized uterine scars, including perforations, may magnify the risk for atypical uterinerupture in the setting of excessive uterine distension.
Spontaneous uterinerupture in the 35th week of gestation after laparoscopic adenomyomectomy Uterinerupture rarely occurs during pregnancy, but it is a critical situation if so. It is already known that a history of uterine surgeries, such as cesarean section or myomectomy, is a risk factor for uterinerupture. Currently, the laparoscopic adenomyomectomy is a widely performed procedure, but associated risks have not been defined. We observed a case of spontaneous uterinerupture in a patient (...) during the 35th week of gestation, after a laparoscopic adenomyomectomy. A 42-year-old, gravida 2, para 0 woman became pregnant after a laparoscopic adenomyomectomy and her pregnancy was conventional. At a scheduled date in the 35th week of gestation, after combined spinal epidural anesthesia and frequent uterine contractions, a weak pain suddenly ensued. After 13 minutes of uterine contractions, vaginal bleeding was evident. A cesarean section was performed, and the uterinerupture was found
An unusual presentation of recurrent uterinerupture during pregnancy We describe a case of recurrent uterinerupture at the site of a previous rupture. Our patient had a history of right interstitial pregnancy with spontaneous uterine fundal rupture at 18 weeks of pregnancy. During her subsequent pregnancy, she was monitored closely by a senior consultant obstetrician. The patient presented at 34 weeks with right hypochondriac pain. She was clinically stable and fetal monitoring showed (...) no signs of fetal distress. Ultrasonography revealed protrusion of the intact amniotic membranes in the abdominal cavity at the uterine fundus. Uterinerupture is a rare but hazardous obstetric complication. High levels of caution should be exercised in patients with a history of prior uterinerupture, as they may present with atypical symptoms. Ultrasonography could provide valuable information in such cases where there is an elevated risk of uterinerupture at the previous rupture site.
Uterinerupture: trends over 40 years. To follow trends of uterinerupture over a period of 40 years in Norway.Population-based study using data from the Medical Birth Registry, the Patient Administration System, and medical records.Norway.Women giving birth in 21 maternity units in Norway during the period 1967-2008 (n = 1 441 712 maternities).The incidence and outcomes of uterinerupture were compared across four decades: 1967-1977; 1978-1988; 1989-1999; and 2000-2008. Multivariable logistic (...) regression was used to determine the odds ratio (OR) for uterinerupture in each decade compared with the second decade.Trends in uterine rupture.We identified 359 uterineruptures. The incidence rates per 10 000 maternities in the first, second, third, and fourth decade were 1.2, 0.9, 1.7, and 6.1, respectively. The ORs for complete and partial ruptures in the fourth versus the second decade were 6.4 (95% confidence interval, 95% CI 3.8-10.8) and 7.2 (95% CI 4.2-12.3), respectively. Significant
Uterinerupture risk after periviable cesarean delivery. To investigate the risk of uterinerupture in women with prior periviable cesarean delivery and prior term cesarean delivery independent of initial incision type.We conducted a retrospective longitudinal cohort study using Washington state birth certificate data and hospital discharge records, identifying primary cesarean deliveries performed at 20-26 weeks and 37-41 weeks of gestation with subsequent delivery between 1989 and 2008. We (...) compared subsequent uterinerupture risk in the two groups considering both primary incision type and subsequent labor induction and augmentation.We identified 456 women with index periviable cesarean delivery and 10,505 women with index term cesarean delivery. Women with index periviable cesarean delivery were younger, more frequently of nonwhite race, more likely to smoke, and more likely to have hypertension. Women in the periviable group had more index classical incisions (42% compared with 1%, P
The Nordic Obstetric Surveillance Study: a study of complete uterinerupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery. To assess the rates and characteristics of women with complete uterinerupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery in the Nordic countries.Prospective, Nordic collaboration.The Nordic Obstetric Surveillance Study (NOSS) collected cases of severe obstetric complications (...) complications were reported in 1019 instances among 605 362 deliveries during the study period. The reported rate of severe blood loss at delivery was 11.6/10 000 deliveries, complete uterinerupture was 5.6/10 000 deliveries, abnormally invasive placenta was 4.6/10 000 deliveries, and peripartum hysterectomy was 3.5/10 000 deliveries. Of the women, 25% had two or more complications. Women with complications were more often >35 years old, overweight, with a higher parity, and a history of cesarean delivery
Uterinerupture disguised by urinary retention following a second trimester induced abortion: a case report. Uterinerupture classically presents with severe abdominal pain, loss of fetal station, vaginal bleeding, and shock.We present a case of uterinerupture presenting as significant urinary retention that occurred following a second trimester abortion induced with mifepristone and misoprostol. Uterinerupture was discovered unexpectedly on diagnostic laparoscopy. The uterinerupture (...) was contained by dense adhesions between the omentum and bladder with the previous uterine cesarean hysterotomy scar.This case highlights the difficulties in diagnosis of abnormal placentation and an unusual presentation of uterinerupture. This case was managed successfully laparoscopically.
Delayed Presentation Of UterineRupture Postpartum. 25584787 2015 07 27 2016 11 25 1097-6868 212 5 2015 May American journal of obstetrics and gynecology Am. J. Obstet. Gynecol. Delayed presentation of uterinerupture postpartum. 680.e1-2 10.1016/j.ajog.2015.01.020 S0002-9378(15)00021-6 Narasimhulu Deepa M DM Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, NY. Electronic address: firstname.lastname@example.org. Shi Susan S Department of Obstetrics and Gynecology (...) , Maimonides Medical Center, Brooklyn, NY. eng Case Reports Journal Article 2015 01 10 United States Am J Obstet Gynecol 0370476 0002-9378 AIM IM Adult Female Humans Obstetric Labor Complications Postpartum Period Pregnancy Tomography, X-Ray Computed Ultrasonography UterineRupture diagnostic imaging Vaginal Birth after Cesarean 2014 09 04 2014 12 29 2015 01 09 2015 1 14 6 0 2015 1 15 6 0 2015 7 28 6 0 ppublish 25584787 S0002-9378(15)00021-6 10.1016/j.ajog.2015.01.020
Gestational choriocarcinoma with uterine serosal metastasis mimicking ruptured ectopic pregnancy: A case report Primary gestational choriocarcinoma is commonly present in the uterus in cases of atypical genital bleeding. Symptoms similar to those of an ectopic pregnancy develop when an extra-uterine lesion is present in the abdominal cavity, and lesions have been detected in the ovaries and fallopian tubes in a number of cases. In the present study, we describe a patient with choriocarcinoma (...) that metastasized to the uterine serosa and caused symptoms similar to those of an ectopic pregnancy. The patient was a 30-year-old female who presented to our hospital with atypical genital bleeding and a positive pregnancy test 3 months after missed abortion at 10 weeks of gestation. Transvaginal ultrasonography revealed the absence of a gestational sac in or outside the uterus, and intra-abdominal bleeding was noted. An ectopic pregnancy was suspected based on these findings, and emergency laparotomy